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General NPI Number Information
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NPI Number | 1396158135
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Entity Type | Organization
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Legal Business Name | BP3 LLC
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Dates
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Enumeration Date | 06/10/2014
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Last Update Date | 11/18/2021
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Provider Practice Location Address
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Address Line | 1802 HARPER RD
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City | BECKLEY
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State | WV
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Zip | 25801-3331
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Country | US
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Telephone | 304-256-2006
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Fax | 304-252-1122
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Provider Business Mailing Address
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Address Line | 104 S EISENHOWER DR
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City | BECKLEY
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State | WV
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Zip | 25801-4930
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Country | US
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Telephone | 681-238-0579
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Fax | 304-253-3982
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Authorized Official
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Title or Position | PHARMACIST
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Name | SID ILANGOVAN
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Credential |
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Telephone | 304-222-3064
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | MP0552410
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License Number State | WV
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